Difference between revisions of "Peritoneum"

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=Benign=
=Benign=
==Benign multicystic mesothelioma==
==Peritoneal implants==
:Should '''not''' be confused with ''[[malignant mesothelioma]]''.
{{Main|Peritoneal implants}}
*[[AKA]] ''peritoneal inclusion cyst''.<ref name=pmid19386139>{{Cite journal  | last1 = Vallerie | first1 = AM. | last2 = Lerner | first2 = JP. | last3 = Wright | first3 = JD. | last4 = Baxi | first4 = LV. | title = Peritoneal inclusion cysts: a review. | journal = Obstet Gynecol Surv | volume = 64 | issue = 5 | pages = 321-34 | month = May | year = 2009 | doi = 10.1097/OGX.0b013e31819f93d4 | PMID = 19386139 }}</ref>
*These are dealt with in the ''ovarian tumours'' article. Broadly speaking they may be: (1) desmoplastic non-invasive, (2) epithelial non-invasive, and (3) ''invasive''.
*[[AKA]] ''inflammatory cyst of the peritoneum''.
*[[AKA]] ''[[mesothelial inclusion cyst]]''. (???)
===General===
*Usually conservative management.
*Serum CA-125 usually low.
*May occur in men.<ref name=pmid12239771>{{Cite journal  | last1 = Cavallaro | first1 = A. | last2 = Murazio | first2 = M. | last3 = Modugno | first3 = P. | last4 = Vona | first4 = A. | last5 = Revelli | first5 = L. | last6 = Potenza | first6 = AE. | last7 = Colli | first7 = R. | title = Benign multicystic mesothelioma of the peritoneum: a case report. | journal = Chir Ital | volume = 54 | issue = 4 | pages = 569-72 | month =  | year =  | doi =  | PMID = 12239771 }}</ref>


===Microscopic===
==Well-differentiated papillary mesothelioma==
Features:<ref name=pmid19386139/><ref name=pmid18349460>{{Cite journal  | last1 = Levy | first1 = AD. | last2 = Arnáiz | first2 = J. | last3 = Shaw | first3 = JC. | last4 = Sobin | first4 = LH. | title = From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation. | journal = Radiographics | volume = 28 | issue = 2 | pages = 583-607; quiz 621-2 | month =  | year =  | doi = 10.1148/rg.282075175 | PMID = 18349460 | URL = http://radiographics.rsna.org/content/28/2/583.full}}</ref>
:Should '''not''' be confused with ''[[malignant mesothelioma]]'' or ''[[benign multicystic mesothelioma]]''.
*Thin-walled, irregular-shaped, cysts - unicystic or multicystic.
*[[AKA]] ''benign papillary mesothelioma''.
**Mesothelial lining.
{{Main|Well-differentiated papillary mesothelioma}}
**Eosinophilic fluid.


Image:
==Peritoneal inclusion cyst==
*[http://radiographics.rsna.org/content/28/2/583/F30.expansion.html Multicystic mesothelioma (rsna.org)].
{{Main|Peritoneal inclusion cyst}}
*[[AKA]] ''inflammatory cyst of the peritoneum''.
*[[AKA]] ''[[mesothelial inclusion cyst]]''.{{fact}}
*[[AKA]] ''benign multicystic mesothelioma''.<ref name=pmid19386139>{{Cite journal  | last1 = Vallerie | first1 = AM. | last2 = Lerner | first2 = JP. | last3 = Wright | first3 = JD. | last4 = Baxi | first4 = LV. | title = Peritoneal inclusion cysts: a review. | journal = Obstet Gynecol Surv | volume = 64 | issue = 5 | pages = 321-34 | month = May | year = 2009 | doi = 10.1097/OGX.0b013e31819f93d4 | PMID = 19386139 }}</ref>
**Should '''not''' be confused with ''[[malignant mesothelioma]]'' and ''[[benign papillary mesothelioma]]''.


=Malignant=
=Malignant=
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===IHC===
===IHC===
*Like serous carcinoma elsewhere - see ''[[ovarian serous carcinoma]]''.
*Like serous carcinoma elsewhere - see ''[[ovarian serous carcinoma]]''.
===Sign out===
Should have comment something like:
<pre>
High-grade serous carcinoma of the ovary/fallopian tube/periteonum is associated
with BRCA1/2 mutation in approximately 20% of patients. Referral to genetic
counseling is recommended.
</pre>
==Malignant mesothelioma==
{{Main|Malignant mesothelioma}}
This is like the tumour found in the pleural cavity.
==Peritoneal metastasis==
*[[AKA]] ''metastatic peritoneal disease''.
{{Main|Metastasis}}
===General===
Common causes:
*Gastrointestinal tract, esp. [[colorectal carcinoma]].
*Gynecologic tract.
Note:
*Peritoneal disease in the context of liver metastases in [[colorectal carcinoma]] contraindicates liver resection.<ref>{{Cite journal  | last1 = Elias | first1 = D. | last2 = Rougier | first2 = P. | last3 = Mankarios | first3 = H. | last4 = Fahrat | first4 = F. | last5 = Lasser | first5 = P. | title = [Resectable liver metastases and synchronous extra-hepatic sites of colorectal origin. Surgical indications]. | journal = Presse Med | volume = 22 | issue = 11 | pages = 515-20 | month = Mar | year = 1993 | doi =  | PMID = 8511077 }}</ref>
===Microscopic===
:See ''[[metastasis]]''.


=See also=
=See also=

Latest revision as of 19:07, 29 April 2022

The peritoneum is a much neglected area, with relatively little pathology. It includes the omentum which is dealt with in the omentum article.

Benign

Peritoneal implants

Main article: Peritoneal implants
  • These are dealt with in the ovarian tumours article. Broadly speaking they may be: (1) desmoplastic non-invasive, (2) epithelial non-invasive, and (3) invasive.

Well-differentiated papillary mesothelioma

Should not be confused with malignant mesothelioma or benign multicystic mesothelioma.
  • AKA benign papillary mesothelioma.
Main article: Well-differentiated papillary mesothelioma

Peritoneal inclusion cyst

Main article: Peritoneal inclusion cyst

Malignant

Primary peritoneal serous carcinoma

General

  • Very rare.
  • Reported in men.[2]

Microscopic

Features:

  • Like serous carcinoma elsewhere - see ovarian serous carcinoma.
  • To exclude ovarian serous carcinoma all of the following criteria must be met:[3]
    1. Histology of the tumour = serous carcinoma.
    2. Bulk of the tumour involves the peritoneum.
    3. Ovarian substance tumour extent less than 5 x 5 mm in plane of section.
    4. Previous ovarian serous carcinoma is excluded.
      • Old oopherectomies reviewed if possible.

DDx:

IHC

Sign out

Should have comment something like: 

High-grade serous carcinoma of the ovary/fallopian tube/periteonum is associated 
with BRCA1/2 mutation in approximately 20% of patients. Referral to genetic 
counseling is recommended.

Malignant mesothelioma

Main article: Malignant mesothelioma

This is like the tumour found in the pleural cavity.

Peritoneal metastasis

  • AKA metastatic peritoneal disease.
Main article: Metastasis

General

Common causes:

Note:

Microscopic

See metastasis.

See also

References

  1. ↑ Vallerie, AM.; Lerner, JP.; Wright, JD.; Baxi, LV. (May 2009). "Peritoneal inclusion cysts: a review.". Obstet Gynecol Surv 64 (5): 321-34. doi:10.1097/OGX.0b013e31819f93d4. PMID 19386139.
  2. ↑ Shmueli, E.; Leider-Trejo, L.; Schwartz, I.; Aderka, D.; Inbar, M. (Apr 2001). "Primary papillary serous carcinoma of the peritoneum in a man.". Ann Oncol 12 (4): 563-7. PMID 11398893.
  3. ↑ Roh, SY.; Hong, SH.; Ko, YH.; Kim, TH.; Lee, MA.; Shim, BY.; Byun, JH.; Woo, IS. et al. (Jun 2007). "Clinical characteristics of primary peritoneal carcinoma.". Cancer Res Treat 39 (2): 65-8. doi:10.4143/crt.2007.39.2.65. PMC 273931. PMID 19746214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC273931/.
  4. ↑ Elias, D.; Rougier, P.; Mankarios, H.; Fahrat, F.; Lasser, P. (Mar 1993). "[Resectable liver metastases and synchronous extra-hepatic sites of colorectal origin. Surgical indications].". Presse Med 22 (11): 515-20. PMID 8511077.
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